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Autism in adult psychiatric out-patients : self-reported suicidal ideation, suicide attempts and non-suicidal self-injury

Nyrenius, Johan LU orcid ; Waern, Margda ; Eberhard, Jonas LU ; Ghaziuddin, Mohammad ; Gillberg, Christopher and Billstedt, Eva (2023) In BJPsych Open 9(5).
Abstract

Background The prevalence of self-reported suicidal ideation, suicide attempts and non-suicidal self-injury (NSSI) remains unclear among adults with autism unrecognised in childhood who attend psychiatric services. Aims We aimed to estimate the prevalence of suicidal ideation, suicide attempts and NSSI; identify factors associated with suicide attempts and NSSI; and describe NSSI in this group. Method Sixty-three new patients at an adult psychiatric out-patient clinic (57% women, mean age 32 years) who met full (n = 52) or subthreshold (two A criteria and minimum of two B criteria; n = 11) DSM-5 criteria for autism spectrum disorder were included in the study. Clinical assessments included overall diagnostic review, Paykel's questions... (More)

Background The prevalence of self-reported suicidal ideation, suicide attempts and non-suicidal self-injury (NSSI) remains unclear among adults with autism unrecognised in childhood who attend psychiatric services. Aims We aimed to estimate the prevalence of suicidal ideation, suicide attempts and NSSI; identify factors associated with suicide attempts and NSSI; and describe NSSI in this group. Method Sixty-three new patients at an adult psychiatric out-patient clinic (57% women, mean age 32 years) who met full (n = 52) or subthreshold (two A criteria and minimum of two B criteria; n = 11) DSM-5 criteria for autism spectrum disorder were included in the study. Clinical assessments included overall diagnostic review, Paykel's questions on passive and active suicidality, evaluation of NSSI with the Functional Assessment of Self-Mutilation, and results of cognitive tests. One follow-up of medical records was made. Results In this sample of psychiatric out-patients identified as first having autism in adulthood, almost a third (31%) of patients reported suicidal ideation during the past month, 86% had lifetime suicidal ideation and 25% reported at least one suicide attempt. Factors associated with suicide attempts included hazardous or harmful alcohol use and/or drug-related problems, and severity of depression. A total of 44% reported NSSI. Factors associated with NSSI were female sex, history of suicidal plans and antisocial personality disorder. Substance or alcohol use were often overlooked, especially in women. Conclusions Suicidal ideation, suicide attempts and NSSI were very common in adults with autism who were recently referred to an out-patient psychiatric service. Suicidal ideation and NSSI were more common than suicide attempts. Clinicians should always consider suicidal ideation and NSSI in adult psychiatric patients with autism.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
adults, Autism, non-suicidal self-injury, out-patient psychiatry, suicide
in
BJPsych Open
volume
9
issue
5
article number
e167
publisher
Cambridge University Press
external identifiers
  • pmid:37674410
  • scopus:85171735754
ISSN
2056-4724
DOI
10.1192/bjo.2023.553
language
English
LU publication?
yes
id
7daaf5f3-4f75-4937-849c-46f06604e8b7
date added to LUP
2023-12-13 15:38:46
date last changed
2024-04-12 07:28:06
@article{7daaf5f3-4f75-4937-849c-46f06604e8b7,
  abstract     = {{<p>Background The prevalence of self-reported suicidal ideation, suicide attempts and non-suicidal self-injury (NSSI) remains unclear among adults with autism unrecognised in childhood who attend psychiatric services. Aims We aimed to estimate the prevalence of suicidal ideation, suicide attempts and NSSI; identify factors associated with suicide attempts and NSSI; and describe NSSI in this group. Method Sixty-three new patients at an adult psychiatric out-patient clinic (57% women, mean age 32 years) who met full (n = 52) or subthreshold (two A criteria and minimum of two B criteria; n = 11) DSM-5 criteria for autism spectrum disorder were included in the study. Clinical assessments included overall diagnostic review, Paykel's questions on passive and active suicidality, evaluation of NSSI with the Functional Assessment of Self-Mutilation, and results of cognitive tests. One follow-up of medical records was made. Results In this sample of psychiatric out-patients identified as first having autism in adulthood, almost a third (31%) of patients reported suicidal ideation during the past month, 86% had lifetime suicidal ideation and 25% reported at least one suicide attempt. Factors associated with suicide attempts included hazardous or harmful alcohol use and/or drug-related problems, and severity of depression. A total of 44% reported NSSI. Factors associated with NSSI were female sex, history of suicidal plans and antisocial personality disorder. Substance or alcohol use were often overlooked, especially in women. Conclusions Suicidal ideation, suicide attempts and NSSI were very common in adults with autism who were recently referred to an out-patient psychiatric service. Suicidal ideation and NSSI were more common than suicide attempts. Clinicians should always consider suicidal ideation and NSSI in adult psychiatric patients with autism.</p>}},
  author       = {{Nyrenius, Johan and Waern, Margda and Eberhard, Jonas and Ghaziuddin, Mohammad and Gillberg, Christopher and Billstedt, Eva}},
  issn         = {{2056-4724}},
  keywords     = {{adults; Autism; non-suicidal self-injury; out-patient psychiatry; suicide}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{5}},
  publisher    = {{Cambridge University Press}},
  series       = {{BJPsych Open}},
  title        = {{Autism in adult psychiatric out-patients : self-reported suicidal ideation, suicide attempts and non-suicidal self-injury}},
  url          = {{http://dx.doi.org/10.1192/bjo.2023.553}},
  doi          = {{10.1192/bjo.2023.553}},
  volume       = {{9}},
  year         = {{2023}},
}